In medicine, sutures have long been used to close serious wounds. More recently, adhesive closures have been introduced that can effectively close some types of wounds without inflicting the additional injury inherent in suturing. These adhesive closures have a backing to provide solid structure, and have an adhesive layer for adhering to the skin. There are two main criteria that must be reconciled in a successful design for these products: reliable adhesion to the skin, even when the wound is adjacent to a joint; and good performance in keeping the wound edges in proximity to each other.
One approach is to use a non-woven web as the basic backing, and to reinforce this material with strong fibers in the longitudinal, or cross-wound, direction. The main substance of the backing can bend with the skin as the patient moves, and the reinforcing fibers strengthen the lightweight backing so that the structure can resist wound edge separation. This backing is combined with a strong skin adhesive over the entire skin contacting surface. The strength of the reinforcing fibers, combined with their secure anchorage immediately adjacent to the wound edges provides excellent security against wound separation. For example, Steri-Strips™ wound closures, commercially available from Minnesota Mining and Manufacturing Company of St. Paul, Minn., are constructed in this way.
One limitation on this approach is partially a psychological one, i.e., concern about the placement of skin adhesive to the area directly above the wound edge. That concern may include an apprehension that the adhesive will stick to the wound edge and re-open the partially healed wound when the closure is removed at the end of treatment. This can, in fact, happen if care is not taken when removing the closures.
To address the problem of adhesion to wound edges, some wound closures include a non-adhesive wound contact layer adhered to the skin adhesive layer over a limited surface area of the underside of the skin adhesive layer, so as to be placed right over the wound. Because such devices are not anchored immediately adjacent the wound edges, the desired dimensional stability to resist wound opening is provided primarily by the backing. For example, Band-Aid Brand Butterfly Closures, commercially available from Johnson & Johnson Company of Skillman, N.J., are constructed in this way. Because the backing is substantially stiff overall, however, it can be difficult to obtain good long-term adhesion adjacent to a joint where, for example, the skin is constantly stretching and unstretching.
Reconciling these approaches to obtain good conformability and adhesion, secure wound edge positioning, and easy release of the product from the wound edge at the end of treatment, would be much appreciated by medical practitioners. Additionally, it would be appreciated if such a wound closure were constructed so as to fit more easily onto body locations were space is at a premium. Cuts to the face over the bony ridge just above the eye, for example, are difficult to treat with existing products since their length carries them onto the eyelid.